Clinical Advances in Periodontics最新文献_第2页

Double-vestibular incision subperiosteal tunnel access (double-VISTA) with connective tissue graft for treating multiple gingival recessions: 2-year follow-up. 双前庭切口骨膜下隧道入路（双vista）联合结缔组织移植物治疗多发性牙龈衰退：2年随访。

IF 0.9 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Advances in Periodontics

Pub Date : 2025-01-15 DOI: 10.1002/cap.10333

Guo-Hao Lin

Background: Gingival recession has a multifactorial etiology, involving various predisposing and precipitating factors. Non-carious cervical lesions (NCCLs) are often associated with gingival recession and pose challenges due to their complex pathodynamics. There is limited evidence regarding tunnel-based procedures combined with connective tissue grafts (CTGs) for treating recession-associated NCCLs. This case study illustrates a periodontal-restorative approach for addressing multiple adjacent recession-associated NCCLs.Methods: A healthy, non-smoking 55-year-old Asian male presented with generalized mucogingival conditions, including gingival recessions and lack of keratinized tissue on the facial aspect of the maxillary right first molar through the left first molar, accompanied by physiological gingival pigmentation. The recessions were classified as Cairo RT I. NCCLs were evident in all six maxillary anterior teeth. After restoring the NCCLs to the maximum root coverage (MRC) level with composite resin, the patient underwent a mucogingival procedure via a double-vestibular incision subperiosteal tunnel access (double-VISTA) approach with autogenous CTG for treating the recession defects. Due to limited CTG availability, the maxillary left side was treated first, followed by the right side 3 months later.Results: Post-surgical healing was uneventful, except for mild facial swelling for 5 days, which subsided within a week. After 12 months, all treated teeth exhibited complete coverage to the predetermined MRC level, with a thick gingival phenotype. At the 2-year follow-up, all treated teeth maintained a stable root coverage outcome with harmonious gingival margins.Conclusion: This case study demonstrates that the double-VISTA technique for treating recession-associated NCCLs is promising in achieving complete coverage at sites where the MRC level was predetermined.Key points: This case study introduces a modified vestibular incision subperiosteal tunnel access (VISTA) technique, termed double-VISTA, which employs two distant vestibular incisions to enhance access for instrumentation and recipient site preparation in the treatment of multiple adjacent recession defects. A periodontal-restorative approach is detailed in this case study, demonstrating a step-by-step process for managing multiple adjacent recession-associated non-carious cervical lesions using the double-VISTA technique with a promising treatment outcome. The advantages and disadvantages of the double-VISTA technique are further discussed in this case study. Limitations of this technique include shallow vestibular depth and close proximity to the mental nerve, necessitating careful attention during recipient site preparation under these conditions.Plain language summary: Gingival recession, where gums recede and expose tooth roots, can resul

背景：牙龈退缩的病因是多因素的，涉及各种诱发和促发因素。非龋性牙颈部病变（NCCL）通常与牙龈退缩有关，由于其复杂的病理动力学，给治疗带来了挑战。目前关于隧道式手术结合结缔组织移植（CTGs）治疗牙龈退缩相关的非龋颈病变的证据还很有限。本病例研究展示了一种牙周修复方法，用于治疗多个邻近衰退相关的 NCCL：一名健康、不吸烟的 55 岁亚裔男性出现了全身粘膜牙龈病症，包括上颌右侧第一磨牙至左侧第一磨牙面部的牙龈凹陷和角化组织缺乏，同时伴有生理性牙龈色素沉着。所有六颗上颌前牙都有明显的 NCCL。用复合树脂将 NCCL 修复到最大牙根覆盖（MRC）水平后，患者通过双前庭切口骨膜下隧道入路（double-VISTA）接受了自体 CTG 治疗衰退缺损的粘龈手术。由于 CTG 供应有限，先治疗上颌左侧，3 个月后再治疗右侧：手术后愈合顺利，只是面部轻微肿胀了 5 天，一周内消退。12 个月后，所有治疗过的牙齿都完全覆盖到了预定的 MRC 水平，牙龈表型厚实。在 2 年的随访中，所有治疗过的牙齿都保持了稳定的牙根覆盖效果，龈缘和谐：本病例研究表明，双 VISTA 技术在治疗退缩相关的 NCCLs 时，有望在 MRC 水平预先确定的部位实现完全覆盖：本病例研究介绍了一种改良的前庭切口骨膜下隧道入路（VISTA）技术，即双VISTA技术，该技术采用两个远端前庭切口，在治疗多个相邻的退缩缺损时，可提高器械和受区准备的入路。本病例研究详细介绍了一种牙周修复方法，展示了使用双 VISTA 技术逐步治疗多发邻面退缩相关的非龋性牙颈病变，并取得了良好的治疗效果。本病例研究进一步讨论了双 VISTA 技术的优缺点。该技术的局限性包括前庭深度较浅，且靠近精神神经，因此在这些条件下准备受术部位时必须小心谨慎。牙颈部的非凹陷性病变（NCCL）通常与这种情况有关，治疗起来具有挑战性。使用隧道式手术和结缔组织移植（CTG）治疗 NCCL 的证据有限。本病例研究介绍了一种治疗多颗相邻NCCL的方法，患者是一名55岁的健康亚裔男子，上牙牙龈萎缩，牙龈色素沉着。患者的六颗上门牙都有非龋坏。首先，用复合树脂覆盖暴露的牙根颈，然后用双前庭切口骨膜下隧道入路（双 VISTA）手术方法和 CTG 解决牙龈退缩问题。由于移植材料有限，先治疗左侧，3 个月后再治疗右侧。患者面部轻微肿胀了 5 天，一周内消肿。12 个月后，所有治疗过的牙齿都显示出完全覆盖，牙龈增厚，而且在 2 年检查时结果保持稳定，牙龈边缘均匀。本病例研究表明，采用双 VISTA 技术治疗 NCCLs 有很好的效果，可以实现完全覆盖，为这类牙科疾病提供了一种可行的治疗方案。

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引用次数: 0

Vitamin C mesotherapy with microneedling for gingival depigmentation: A case study. 维生素C微针疗法治疗牙龈色素沉着：一个案例研究。

IF 0.9 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Advances in Periodontics

Pub Date : 2025-01-15 DOI: 10.1002/cap.10327

Anika Dawar, Razia Haidrus, Sumit Kumar Das

Background: Surgical methods of gingival depigmentation can be challenging, particularly if the gingival phenotype is thin due to the risk of gingival recession and bone exposure. Thus, exploring alternative, non-surgical, minimally invasive treatment modalities is warranted. In dermatology, vitamin C is extensively used for depigmentation and microneedling for collagen induction, with limited literature about its usage for improving gingival esthetics. The present preliminary case study aims to explore the synergistic use of vitamin C mesotherapy with microneedling for the esthetic management of physiologic melanin gingival hyperpigmentation.Methods: Eleven arches from six patients having anterior physiologic melanin hyperpigmentation were recruited. Microneedling was done with a lancet, followed by intra-epidermal administration of 1.5-2 mL of vitamin C in pigmented gingiva (once weekly/four sessions). Dummett oral pigmentation index (DOPI), gingival pigmentation index (GPI), pigmented surface area (PSA), and gingival luminescence (L*) were assessed at baseline and follow-up visits of 1 week, 1 month, and 3 months. Gingival thickness (GT) was recorded at baseline and 3 months. Pain, itching, and gingival color were also assessed.Results: A significant reduction (p < 0.05) in mean DOPI, GPI, and PSA was observed from baseline to 3 months, while L* and GT increased significantly within that timeframe. Patients reported an improvement in gingival color at 1 and 3 months. Low pain and itching scores were obtained post-treatment.Conclusion: Vitamin C mesotherapy with microneedling is a newer, minimally invasive approach that can effectively reduce gingival melanin pigmentation intensity and extent, and can potentially increase the gingival thickness.Key points: Vitamin C mesotherapy (intra-epidermal injection) is an effective and minimally invasive treatment modality for gingival depigmentation. The adjunctive use of microneedling with vitamin C mesotherapy can potentially increase gingival thickness non-surgically. Non-surgical methods for gingival depigmentation can be chosen as an alternative to surgical methods for esthetic management of physiologic melanin hyperpigmentation in cases with thin gingival phenotype.Plain language summary: Patients seek treatment for hyperpigmented gingiva caused by increased melanin to improve the smile esthetics. Conventional surgical methods for gingival depigmentation, however, are challenging to perform in areas of thin gingiva as there is an increased risk of gingival damage and bone exposure. Thus, exploring alternative, non-surgical, minimally invasive options will be advantageous. In dermatology, vitamin C is a popular agent for treating skin hyperpigmentation, and microneedling is a technique used for collagen induction. This preliminary case study synergistically used

背景：牙龈脱色的手术方法可能是具有挑战性的，特别是如果由于牙龈萎缩和骨暴露的风险而导致牙龈表型薄。因此，探索替代的、非手术的、微创的治疗方式是必要的。在皮肤病学中，维生素C被广泛用于脱色和微针诱导胶原蛋白，但关于其用于改善牙龈美观的文献有限。本初步病例研究旨在探讨维生素C微针疗法在生理性黑色素牙龈色素沉着的美学管理中的协同作用。方法：选取6例前路生理性黑色素色素沉着患者的11个弓。用刺胳针进行微针穿刺，然后在着色牙龈表皮内给予1.5-2 mL维生素C（每周一次/四次）。在基线和随访1周、1个月和3个月时评估口腔色素沉着指数（DOPI）、牙龈色素沉着指数（GPI）、色素沉着表面积（PSA）和牙龈发光（L*）。在基线和3个月时记录牙龈厚度（GT）。疼痛、瘙痒和牙龈颜色也进行了评估。结果：从基线到3个月，平均DOPI、GPI和PSA显著降低（p < 0.05），而L*和GT在此时间段内显著升高。患者报告在1个月和3个月时牙龈颜色有所改善。治疗后疼痛和瘙痒评分较低。结论：微针维C化疗是一种较新的微创治疗方法，可有效降低牙龈黑色素沉着的强度和程度，并有可能增加牙龈厚度。重点：维生素C美施疗法（表皮内注射）是一种有效的微创治疗牙龈色素沉着的方法。辅助使用微针与维生素C化疗可以潜在地增加牙龈厚度非手术。对于薄型牙龈患者，可以选择非手术方法治疗牙龈色素沉着，以替代手术方法对生理性黑色素色素沉着进行美学治疗。简单的语言总结：患者寻求治疗由黑色素增加引起的牙龈色素沉着，以改善微笑的美感。然而，传统的牙龈脱色手术方法在薄牙龈区域是具有挑战性的，因为有牙龈损伤和骨暴露的风险增加。因此，探索替代的、非手术的、微创的选择将是有利的。在皮肤病学中，维生素C是治疗皮肤色素沉着的常用药物，微针是一种用于诱导胶原蛋白的技术。这个初步的案例研究协同使用局部维生素C注射（美索疗法）在牙龈微针治疗牙龈色素沉着，从6个病人的11个弓。用刺胳针进行微针注射，然后在色素牙龈表皮内注射1.5-2 mL维生素C（每周一次，共4次）。从基线到三个月，通过临床和摄影参数评估，观察到黑色素沉着强度和程度显著降低。在这段时间内，牙龈厚度明显增加。患者报告了良好的结果，牙龈颜色改善，疼痛和瘙痒评分低。微针治疗维生素C是一种较新的、微创的、有效的、非手术的治疗方式，可以实现牙龈色素沉着和改善牙龈厚度。这些结果需要在未来大样本量和长期随访的研究中进一步验证。

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引用次数: 0

Novel triangle papilla access approach for interdental bone defect regeneration: A case study. 新型三角乳头入路修复牙间骨缺损一例研究。

IF 0.9 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Advances in Periodontics

Pub Date : 2025-01-15 DOI: 10.1002/cap.10335

Yuichiro Ihara, Shunichi Shibazaki, Satoru Morikawa, Taneaki Nakagawa

Background: Successful periodontal regeneration depends on primary wound closure and interdental papilla preservation. In this case study, we introduce a novel triangle papilla access approach (T-PAA) performed under a surgical microscope for treating interdental bone defects. In this novel approach, buccal incisions were used to access root surfaces and bone defects, avoiding interdental papilla incisions and preventing papillary collapse and necrosis.Methods: Nine patients with a mean age of 56 years were enrolled in this study. Incisions were made to create a triangular flap, which was reflected using a micro-periosteal elevator to expose the bone defect and granulation tissue. Subsequently, the granulation tissue was removed from the bone defect using a microsurgical blade, followed by root debridement using ultrasonic and micro-hand scalers and root conditioning. Thereafter, a mixture of fibroblast growth factor-2 and carbonated apatite granules was applied to the bone defect. The triangular flap was repositioned to ensure that the apex was not lifted by the graft material, and from the flap apex, 7-0 nylon sutures were used, followed by the addition of mesial and distal sutures. Adjacent teeth were splinted using wire and resin cement.Results: Postoperatively, clinical and radiographic evaluations at 6 months and 1 year showed significant improvements in periodontal parameters and bone filling. All patients achieved primary wound closure with no postoperative complications.Conclusions: T-PAA is a promising approach for periodontal regeneration, providing adequate surgical access under a surgical microscope while preserving the papilla and potentially improving clinical outcomes in patients with interdental bone defects.Key points: Triangle papilla access approach (T-PAA) provides adequate surgical access, preserves the interdental papillae, and improves clinical outcomes in cases of interdental bone defects. Triangular incisions made in areas with abundant blood flow and thicker gingiva at the base of the papilla are less likely to impair blood supply to the interdental papillae. T-PAA facilitates effective debridement, precise placement of regenerative materials, and accurate flap repositioning regardless of the defect morphology in localized interdental areas.Plain language summary: Successful periodontal treatment often requires surgical procedures for bone regeneration in patients with bone defects. However, traditional surgical approaches may damage the interdental papillae, leading to esthetic concerns and compromised healing. In this study, we introduced a new surgical technique called the triangle papilla access approach, which uses a specially designed triangular incision to access and treat bone defects under a surgical microscope while preserving the interdental papillae. Our results from nin

背景：成功的牙周再生取决于初级伤口闭合和牙间乳头的保留。在本病例研究中，我们介绍了一种在手术显微镜下治疗牙间隙骨缺损的新型三角乳头入路（T-PAA）。在这种新方法中，使用颊切口进入牙根表面和骨缺损，避免了牙间乳头切口，防止了乳头塌陷和坏死：本研究共纳入九名患者，平均年龄 56 岁。切口用于制作三角形皮瓣，使用微型骨膜提升器对皮瓣进行反射，以暴露骨缺损和肉芽组织。随后，用显微外科刀片将肉芽组织从骨缺损处切除，再用超声波和显微手用洁牙器进行根部清创和根部修整。之后，在骨缺损处涂抹成纤维细胞生长因子-2 和碳酸磷灰石颗粒的混合物。调整三角瓣的位置，确保瓣顶不会被移植材料抬起，从瓣顶开始使用 7-0 尼龙线缝合，然后再加上中线和远线缝合。使用金属丝和树脂粘合剂对相邻牙齿进行夹板固定：术后 6 个月和 1 年的临床和影像学评估显示，牙周参数和骨填充均有显著改善。所有患者都实现了伤口的初次闭合，且无术后并发症：T-PAA是一种很有前景的牙周再生方法，它能在手术显微镜下提供充分的手术入路，同时保留乳头，并有可能改善牙间隙骨缺损患者的临床疗效：三角乳头入路法（T-PAA）可提供充分的手术入路，保留牙间乳头，改善牙间骨缺损病例的临床疗效。在乳头基底血流丰富、牙龈较厚的区域进行三角切口，不容易影响牙间乳头的血液供应。无论局部牙间缺损区域的形态如何，T-PAA 都能促进有效的清创、再生材料的精确放置和皮瓣的准确复位。然而，传统的手术方法可能会损伤牙间乳头，导致美观问题和愈合受损。在这项研究中，我们引入了一种名为三角乳头入路的新手术技术，该技术使用专门设计的三角切口，在手术显微镜下对骨缺损进行入路和治疗，同时保留牙间乳头。我们对九名患者的研究结果表明，这种技术能有效保持组织健康并促进骨再生。因此，它可以成为治疗牙间隙骨缺损的一种更有效的方法。

{"title":"Novel triangle papilla access approach for interdental bone defect regeneration: A case study.","authors":"Yuichiro Ihara, Shunichi Shibazaki, Satoru Morikawa, Taneaki Nakagawa","doi":"10.1002/cap.10335","DOIUrl":"https://doi.org/10.1002/cap.10335","url":null,"abstract":"Background: Successful periodontal regeneration depends on primary wound closure and interdental papilla preservation. In this case study, we introduce a novel triangle papilla access approach (T-PAA) performed under a surgical microscope for treating interdental bone defects. In this novel approach, buccal incisions were used to access root surfaces and bone defects, avoiding interdental papilla incisions and preventing papillary collapse and necrosis.Methods: Nine patients with a mean age of 56 years were enrolled in this study. Incisions were made to create a triangular flap, which was reflected using a micro-periosteal elevator to expose the bone defect and granulation tissue. Subsequently, the granulation tissue was removed from the bone defect using a microsurgical blade, followed by root debridement using ultrasonic and micro-hand scalers and root conditioning. Thereafter, a mixture of fibroblast growth factor-2 and carbonated apatite granules was applied to the bone defect. The triangular flap was repositioned to ensure that the apex was not lifted by the graft material, and from the flap apex, 7-0 nylon sutures were used, followed by the addition of mesial and distal sutures. Adjacent teeth were splinted using wire and resin cement.Results: Postoperatively, clinical and radiographic evaluations at 6 months and 1 year showed significant improvements in periodontal parameters and bone filling. All patients achieved primary wound closure with no postoperative complications.Conclusions: T-PAA is a promising approach for periodontal regeneration, providing adequate surgical access under a surgical microscope while preserving the papilla and potentially improving clinical outcomes in patients with interdental bone defects.Key points: Triangle papilla access approach (T-PAA) provides adequate surgical access, preserves the interdental papillae, and improves clinical outcomes in cases of interdental bone defects. Triangular incisions made in areas with abundant blood flow and thicker gingiva at the base of the papilla are less likely to impair blood supply to the interdental papillae. T-PAA facilitates effective debridement, precise placement of regenerative materials, and accurate flap repositioning regardless of the defect morphology in localized interdental areas.Plain language summary: Successful periodontal treatment often requires surgical procedures for bone regeneration in patients with bone defects. However, traditional surgical approaches may damage the interdental papillae, leading to esthetic concerns and compromised healing. In this study, we introduced a new surgical technique called the triangle papilla access approach, which uses a specially designed triangular incision to access and treat bone defects under a surgical microscope while preserving the interdental papillae. Our results from nin","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Biologically-oriented alveolar ridge preservation to correct bone dehiscence at immediate implant placement. 生物定向牙槽嵴保存以纠正即刻种植体放置时的骨裂。

IF 0.9 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Advances in Periodontics

Pub Date : 2025-01-15 DOI: 10.1002/cap.10334

Leonardo Trombelli, Tommaso Grenzi

Background: The purpose of the present case study is to describe the application of a modification of the Biologically-oriented Alveolar Ridge Preservation (BARP) principles in cases of peri-implant bone dehiscence (PIBD) due to a compromised alveolus at immediate implant placement (IIP).

Methods: The technique is based on the stratification of three layers: a deep layer with a collagen sponge (CS) in the apical part of the alveolus (where the buccal bone plate was still present) to support the blood clot; a graft layer to correct the PIBD; and a superficial collagen layer to cover the graft thus providing space and enhancing clot/graft stability. Healing was obtained by primary closure.

Results: At the re-entry procedure for implant uncovering, a complete PIBD correction with newly formed peri-implant bone up to the level of the polished collar was observed in both cases.

Conclusions: These observations suggest that BARP based on the combined use of CS and deproteinized bovine bone mineral may be regarded as a simplified treatment option to correct a PIBD at IIP.

Key points: Why treat a Peri-Implant Bone Dehiscence (PIBD)? PIBD should be treated to avoid biological and esthetic complications over time. What plays a key role in this case? The stability of both the graft and the cloth is essential for providing space for bone formation to correct the PIBD; the extraction socket supports angiogenic and osteogenic properties; Primary intention closure is crucial to prevent potential infection.

Limitation: the efficacy of the technique must be assessed.

Plain language summary: This case study described the potential to correct a post-extraction osseous defect associated with a substantial portion of a dental implant which resulted exposed and without bone support on its buccal aspect. The application of a novel bone augmentation technique, namely the biologically oriented Alveolar Ridge Preservation, has been described. This simplified procedure is based on the stratification of i) a deep collagen layer in the apical part of the socket to support the blood clot and spontaneous bone formation, ii) a graft of bone substitute to correct the missing bone, and iii) a superficial collagen layer to protect the graft and the wound. After 5 months, a complete correction of the osseous defect with newly formed bone up to the head of the implant was observed in both treated cases.

背景：本病例研究的目的是描述生物定向牙槽嵴保存（BARP）原则的修改在种植体周围骨裂（PIBD）病例中的应用，这是由于立即种植体放置（IIP）时牙槽嵴受损。方法：该技术基于三层分层：在牙槽骨顶端（颊骨板仍然存在的地方）使用胶原海绵（CS）的深层层来支撑血凝块；植骨层矫正PIBD；表面的胶原蛋白层覆盖移植物，从而提供空间并增强凝块/移植物的稳定性。通过初级闭合获得愈合。结果：在种植体揭露的再入手术中，两例患者均观察到新形成的种植体周围骨达到抛光项圈水平的完整PIBD矫正。结论：这些观察结果表明，基于CS和脱蛋白牛骨矿物质联合使用的BARP可能被视为纠正IIP PIBD的简化治疗选择。重点：为什么要治疗种植体周围骨裂（PIBD）？随着时间的推移，PIBD的治疗应避免生物和美学并发症。在这个案例中，什么起了关键作用？移植物和布的稳定性对于为骨形成提供空间以纠正PIBD至关重要；拔牙槽支持血管生成和成骨特性；初级意向闭合对于预防潜在感染至关重要。局限性：该技术的有效性必须进行评估。简单的语言总结：本病例研究描述了矫治拔牙后骨缺损的潜力，该骨缺损与牙种植体的大部分相关，导致其颊部暴露且无骨支撑。一种新的骨增强技术的应用，即生物定向牙槽嵴保存，已经被描述。这个简化的程序是基于以下层的分层：1)在眼窝顶端的深层胶原蛋白层，以支持血凝块和自发骨形成；2)骨替代物移植物，以纠正缺失的骨；3)浅层胶原蛋白层，以保护移植物和伤口。5个月后，观察到两个治疗病例的骨缺损完全矫正，新形成的骨一直到种植体的头部。

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引用次数: 0

Clinical management of hereditary gingival fibromatosis: Case report with 13 years follow-up. 遗传性牙龈纤维瘤病的临床治疗：13年随访1例。

IF 0.9 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Advances in Periodontics

Pub Date : 2025-01-15 DOI: 10.1002/cap.10331

Alcione Maria Soares Dutra Oliveira, Peterson Antônio Dutra Oliveira, Tarcísio Junqueira Pereira, Fernando Oliveira Costa

Background: Hereditary gingival fibromatosis (HGF) is one of the categories of non-plaque-induced gingival diseases of genetic origin. Current studies show high genetic heterogeneity and suggest that not all forms of HGF are the same and that more than one biological mechanism may result in gingival growth. This report presents a case of syndromic HGF with generalized and complex clinical manifestations associated with other conditions such as body hypertrichosis and hearing deficit.

Methods: This is a case report of a male patient with HGF, detailing the orthodontic and periodontal management that began at the age of 8 and was completed by 21.

Results and conclusions: The results of this case report demonstrated the importance of early diagnosis and the establishment of a correct treatment plan that provided, in the long-term, highly positive effects, minimizing impacts affecting the oral health-related quality of life of individuals with HGF.

Key points: This is a case report of a male patient with HGF, detailing the orthodontic and periodontal management that began at age 8 and was completed by age 21. Clinical, genetic, and histological data are reported over the 13 years of follow-up. Due to the numerous complications caused by HGF, early diagnosis and the establishment of an appropriate treatment plan are imperative.

背景：遗传性牙龈纤维瘤病（HGF）是一类非菌斑诱导的遗传性牙龈疾病。目前的研究显示出高度的遗传异质性，并表明并非所有形式的HGF都是相同的，并且不止一种生物机制可能导致牙龈生长。本报告提出一例综合征型HGF，具有全身和复杂的临床表现，并伴有其他疾病，如体多毛和听力缺陷。方法：这是一个男性HGF患者的病例报告，详细描述了从8岁开始到21岁完成的正畸和牙周管理。结果和结论：本病例报告的结果表明早期诊断和建立正确的治疗计划的重要性，从长期来看，提供高度积极的效果，最大限度地减少对HGF患者口腔健康相关生活质量的影响。重点：这是一个男性HGF患者的病例报告，详细描述了从8岁开始到21岁完成的正畸和牙周管理。在13年的随访中报告了临床、遗传和组织学数据。由于HGF引起的许多并发症，早期诊断和制定适当的治疗计划是必不可少的。

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引用次数: 0

Surgically facilitated orthodontics with clear aligners for severe malocclusion and gingival recessions. 手术促进正畸与明确对准严重错牙合和牙龈衰退。

IF 0.9 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Advances in Periodontics

Pub Date : 2025-01-09 DOI: 10.1002/cap.10324

Elli Anna Kotsailidi, Lucy Johnson, Christopher Burns, Paul Emile Rossouw, Dimitrios Michelogiannakis

Background: Gingival recession defects (GRDs) pose functional and esthetic concerns and may be associated with unfavorable tooth positions. Surgically facilitated orthodontic treatment (SFOT) with clear aligners can be a valuable option for adults with severe malocclusion and GRDs.Methods: A 28-year-old male presented with severe dental crowding, Class III dental malocclusion, localized tooth crossbites, and tapered maxillary arch. He exhibited multiple gingival recessions type I up to 6 mm in depth, at least 2 mm of keratinized tissue throughout, and a thick scalloped gingival phenotype. Clear aligner SFOT was performed including buccal corticotomies and bone augmentation with demineralized allograft between the first molars on both arches, dental expansion, interproximal enamel reduction, and use of intermaxillary elastics. Progress of the aligners occurred every 3 days for the first 6 months; and every 5 days thereafter, for a total duration of 10.5 months.Results: Clear aligner SFOT led to tooth alignment, Class I occlusion, and improvement in smile esthetics. Complete root coverage was achieved on 50% of the teeth and the mean root coverage was 81.6%, ranging from 1 to 6 mm, while residual GRDs ranged from 1 to 2 mm.Conclusion: Clear aligner SFOT can be a valuable interdisciplinary approach for the management of adults with multiple GRDs and severe malocclusion.Plain language summary: Recession of the gingiva creates functional and esthetic concerns and is often related to unfavorable tooth position and tooth crowding. A surgical procedure called "surgically facilitated orthodontic treatment" (SFOT) with clear aligners instead of metal braces is a valuable treatment option for adults with receding gingiva and unfavorable tooth position. This report presents a 28-year-old male with severe tooth crowding and narrow tooth arches. He had several areas with thick, receding gingiva on the upper and lower jaws. The surgery involved the creation of bony cuts in between the roots, followed by bone grafting over the roots and cuts, on both jaws. The orthodontic treatment was executed with clear aligners and elastics. The patient was switching aligners every 3 days for the first 6 months and every 5 days thereafter. The total treatment duration was 10.5 months. Eventually, clear aligner SFOT led to the alignment of all teeth and improved the appearance of the smile. Receding gingiva was completely reversed on 50% of the teeth and improved by a mean of 81.6% (1-6 mm gain in gingiva). This report exhibits that this technique can be a valuable treatment approach for patients with multiple areas of receding gingiva, unfavorable tooth position, and crowding.Key points: This case is the first to illustrate the successful management of multiple and severe gingival recession defects along with severe malocclusion with clea

背景：牙龈退缩缺陷（GRDs）引起功能和美学问题，并可能与不利的牙位有关。手术辅助正畸治疗（SFOT）与明确对准器可以是一个有价值的选择成人严重错牙合和GRDs。方法：一名28岁男性患者，表现为重度牙拥挤，III级牙错颌，局部牙交叉咬合，上颌弓变细。他表现出多重牙龈衰退，深度达6毫米，至少2毫米的角化组织，以及厚的扇形牙龈表型。我们进行了明确的矫正术，包括颊皮质切开术和在双弓第一磨牙之间进行脱矿同种异体骨移植，牙齿扩张，近端间牙釉质复位，以及使用上颌间弹性。前6个月每3天进行一次矫正器的进展；此后每5天进行一次，共10.5个月。结果：清除矫正器SFOT使牙齿对准，I级咬合，改善微笑美观。50%的牙根完全覆盖，平均覆盖81.6%，覆盖范围为1 ~ 6mm，剩余GRDs范围为1 ~ 2mm。结论：清除矫正器SFOT是治疗成人多重GRDs和严重错颌的一种有价值的跨学科方法。简单的语言总结：牙龈的衰退引起功能和审美方面的担忧，并且通常与不利的牙齿位置和牙齿拥挤有关。一种被称为“外科促进正畸治疗”（SFOT）的外科手术，用透明矫正器代替金属牙套，对于牙龈后退和牙齿位置不利的成年人来说是一种有价值的治疗选择。本文报告一位28岁男性患者，患有严重的牙齿拥挤和狭窄的牙弓。他的上颚和下颚有几处地方的牙龈又厚又退。手术包括在牙根之间做骨切口，然后在牙根和切口上进行骨移植。正畸治疗采用透明矫正器和弹性矫正器。患者在前6个月每3天更换一次矫正器，此后每5天更换一次。总治疗时间10.5个月。最终，矫正器SFOT矫正了所有牙齿，改善了笑容的外观。50%的牙齿牙龈萎缩完全逆转，平均改善81.6%（牙龈增加1-6毫米）。本报告显示，这种技术可以是一个有价值的治疗方法，多区域的牙龈后退，不利的牙齿位置，和拥挤的患者。重点：本病例首次展示了在不进行软组织移植的情况下，采用透明矫正器手术辅助正畸治疗多种严重牙龈后退缺陷并严重错牙合的成功治疗。正畸牙齿移动和手术过程数字化规划和执行，对准器更换频率根据区域加速现象每3天更换一次。在牙槽内适当的牙齿定位以及骨增加导致牙龈衰退的减少/解决，而不需要软组织移植。

{"title":"Surgically facilitated orthodontics with clear aligners for severe malocclusion and gingival recessions.","authors":"Elli Anna Kotsailidi, Lucy Johnson, Christopher Burns, Paul Emile Rossouw, Dimitrios Michelogiannakis","doi":"10.1002/cap.10324","DOIUrl":"https://doi.org/10.1002/cap.10324","url":null,"abstract":"Background: Gingival recession defects (GRDs) pose functional and esthetic concerns and may be associated with unfavorable tooth positions. Surgically facilitated orthodontic treatment (SFOT) with clear aligners can be a valuable option for adults with severe malocclusion and GRDs.Methods: A 28-year-old male presented with severe dental crowding, Class III dental malocclusion, localized tooth crossbites, and tapered maxillary arch. He exhibited multiple gingival recessions type I up to 6 mm in depth, at least 2 mm of keratinized tissue throughout, and a thick scalloped gingival phenotype. Clear aligner SFOT was performed including buccal corticotomies and bone augmentation with demineralized allograft between the first molars on both arches, dental expansion, interproximal enamel reduction, and use of intermaxillary elastics. Progress of the aligners occurred every 3 days for the first 6 months; and every 5 days thereafter, for a total duration of 10.5 months.Results: Clear aligner SFOT led to tooth alignment, Class I occlusion, and improvement in smile esthetics. Complete root coverage was achieved on 50% of the teeth and the mean root coverage was 81.6%, ranging from 1 to 6 mm, while residual GRDs ranged from 1 to 2 mm.Conclusion: Clear aligner SFOT can be a valuable interdisciplinary approach for the management of adults with multiple GRDs and severe malocclusion.Plain language summary: Recession of the gingiva creates functional and esthetic concerns and is often related to unfavorable tooth position and tooth crowding. A surgical procedure called \"surgically facilitated orthodontic treatment\" (SFOT) with clear aligners instead of metal braces is a valuable treatment option for adults with receding gingiva and unfavorable tooth position. This report presents a 28-year-old male with severe tooth crowding and narrow tooth arches. He had several areas with thick, receding gingiva on the upper and lower jaws. The surgery involved the creation of bony cuts in between the roots, followed by bone grafting over the roots and cuts, on both jaws. The orthodontic treatment was executed with clear aligners and elastics. The patient was switching aligners every 3 days for the first 6 months and every 5 days thereafter. The total treatment duration was 10.5 months. Eventually, clear aligner SFOT led to the alignment of all teeth and improved the appearance of the smile. Receding gingiva was completely reversed on 50% of the teeth and improved by a mean of 81.6% (1-6 mm gain in gingiva). This report exhibits that this technique can be a valuable treatment approach for patients with multiple areas of receding gingiva, unfavorable tooth position, and crowding.Key points: This case is the first to illustrate the successful management of multiple and severe gingival recession defects along with severe malocclusion with clea","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Saving a hopeless tooth with a four-wall bone defect: A case report. 挽救一颗四壁骨缺损的牙：1例报告。

IF 0.9 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Advances in Periodontics

Pub Date : 2024-12-23 DOI: 10.1002/cap.10329

Takayoshi Nagahara, Tomoyuki Iwata, Keinoshin Wada, Tomoya Ueda, Shoko Kono, Kazuhisa Ouhara, Noriyoshi Mizuno

Background: Recombinant human fibroblast growth factor-2 (rhFGF-2) has been shown to effectively promote the formation of new periodontal tissues, and its efficacy has been demonstrated in clinical settings. Moreover, the clinical and radiographic outcomes in the treatment of periodontal infrabony defects can be improved by using rhFGF-2 in combination with a bone substitute. Here, we present a case of four-wall bone defect in a tooth treated by combination regenerative therapy using rhFGF-2 and beta-tricalcium phosphate (β-TCP).

Methods: A 43-year-old male with a four-wall bone defect in tooth #28 was subjected to combination therapy with rhFGF-2 and β-TCP. Periodontal clinical parameters and radiographic images were evaluated at the first visit, after the initial periodontal treatment, and after 4 months and 4 years postoperation.

Results: Although gingival recession and nonvital pulp were observed postoperation, improvements in the periodontal parameters and radiographic outcomes were subsequently recorded.

Conclusion: Periodontal regenerative therapy with a combination of rhFGF-2 and β-TCP showed great potential in the treatment of four-wall bone defects of teeth.

Key points: Periodontal regenerative therapy using recombinant human fibroblast growth factor-2 (rhFGF-2) and beta-tricalcium phosphate (β-TCP) showed immense potential in the treatment of four-wall bone defect in teeth. In addition to using computed tomography for assessing bone defects and root morphologies, an evaluation of root canal morphology and pulp diagnosis is essential for understanding the internal and external aspects of the defect, which would aid in tooth preservation. Appropriate periodontal and endodontic treatments enabled tooth preservation following apical periodontitis after periodontal regenerative therapy.

Plain language summary: This case report focuses on a new approach for the treatment of a four-wall bone defect, a significant dental issue in which the bone around the tooth is damaged, thereby decreasing the stability of the tooth. We treated a 43-year-old male patient with a combination of two key components: the growth factor rhFGF-2, which helps promote the growth of new tissues, and the synthetic bone graft substitute β-TCP, which acts as a substitute for the missing bone. Over the course of 4 years, we monitored the patient's progress using dental exams and X-ray photos. Despite some minor side effects, such as gum recession and the loss of tooth vitality, the overall condition of the tooth and surrounding bone showed significant improvement. This combination therapy shows promise in repairing similar bone defects, which would help save teeth that might otherwise be lost.

背景：重组人成纤维细胞生长因子-2 （rhFGF-2）已被证明能有效促进新牙周组织的形成，其疗效已在临床环境中得到证实。此外，使用rhFGF-2联合骨替代物治疗牙周下骨缺损的临床和影像学结果可以得到改善。在这里，我们报告了一个用rhFGF-2和β-磷酸三钙（β-TCP）联合再生疗法治疗牙齿四壁骨缺损的病例。方法：采用rhFGF-2和β-TCP联合治疗28号牙四壁骨缺损的43岁男性患者。在首次就诊、初次牙周治疗后、术后4个月和4年分别评估牙周临床参数和影像学图像。结果：虽然术后观察到牙龈萎缩和无生机的牙髓，但随后记录了牙周参数和影像学结果的改善。结论：结合rhFGF-2和β-TCP进行牙周再生治疗在治疗牙四壁骨缺损方面具有很大的潜力。利用重组人成纤维细胞生长因子-2 （rhFGF-2）和β-磷酸三钙（β-TCP）进行牙周再生治疗，在治疗牙齿四壁骨缺损方面显示出巨大的潜力。除了使用计算机断层扫描来评估骨缺损和牙根形态外，评估根管形态和牙髓诊断对于了解缺损的内部和外部方面至关重要，这将有助于牙齿保存。适当的牙周治疗和牙髓治疗使牙周再生治疗后的根尖牙周炎患者的牙齿得以保存。简单的语言总结：本病例报告的重点是一种治疗四壁骨缺损的新方法，这是一种重要的牙齿问题，其中牙齿周围的骨被破坏，从而降低了牙齿的稳定性。我们治疗了一位43岁的男性患者，使用了两种关键成分的组合：一种是生长因子rhFGF-2，它有助于促进新组织的生长，另一种是合成骨移植替代物β-TCP，它可以替代缺失的骨。在4年的过程中，我们通过牙科检查和x光照片监测患者的进展。尽管有一些小的副作用，比如牙龈萎缩和牙齿失去活力，但牙齿和周围骨骼的整体状况有了明显的改善。这种联合疗法有望修复类似的骨缺损，这将有助于保存可能丢失的牙齿。

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引用次数: 0

Odontogenic keratocyst management using guided tissue regeneration: Literature review - Two case reports. 引导组织再生治疗牙源性角化囊肿：文献回顾-两例报告。

IF 0.9 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Advances in Periodontics

Pub Date : 2024-12-19 DOI: 10.1002/cap.10316

Bassam M Kinaia, Mirranda Kinaia, Joshua Graham, Naiomy Perez Villaneuva, David Van Winkle, Anmar Dawood, Anthony L Neely

Background: Odontogenic cysts of the jaws are pathologies that require timely recognition and management. The initial diagnosis is based on clinical and radiographic appearance and dental history. A variety of surgical treatments are used for odontogenic keratocyst (OKC) depending on the clinical and radiographic presentation. The aim of this report and literature review is to highlight methods to treat OKC combined with guided tissue regeneration (GTR).Methods: Two cases with similar clinical presentations are included. Case 1 was a 60-year-old healthy Caucasian female who presented with jaw expansion around teeth #'s 21 and 22. Initial exam revealed clinical gingival health on an intact periodontium. The patient presented with enlarged gingival tissue between teeth #'s 21 and 22 measuring 9 × 12 mm and vital teeth without root displacement radiographically. Case 2 had a similar clinical and radiographic presentation located between teeth #'s 5-6.Results: Case 1 treatment included excisional biopsy with complete enucleation of the cystic lesion. Thereafter, GTR was performed using allograft internally then covered with a xenograft externally, resorbable collagen membrane (RCM), and primary closure. Case 2 was managed with excisional biopsy with lesion enucleation, GTR with allogenic bone graft, enamel matrix derivative and RCM, and primary closure.Conclusion: OKC enucleation combined with GTR using mineralized allograft, enamel matrix derivative, and collagen membrane or a layering technique of allograft internally and xenograft externally covered by a collagen membrane showed proper regeneration with stable periodontium at 6-36 months.Key points: Guided tissue regeneration is an acceptable treatment for management of OKC. Complete enucleation of an OKC lesion is important to reduce recurrence. The use of allograft with xenograft or allograft with enamel matrix derivative and RCM can provide proper bone fill after OKC removal.Plain language summary: Odontogenic cysts are growths that can form in the jaw or soft tissues around the teeth. If not treated, they can grow larger, damage the bone, and even push teeth out of place. To prevent this, it's important to diagnose and remove them early. The most common way to treat these cysts is through a surgical method called enucleation, where the cyst is carefully removed. In these two cases, enucleation was used along with guided tissue regeneration, a technique to help the bone and tissue heal better after surgery. In the first case, a bone graft (made from human and animal bone) and a special material called a resorbable collagen membrane were used to protect and support the healing area. In the second case, a mineralized bone graft along with a substance that helps repair tissues called an enamel matrix derivative, and the same collagen membrane were used. Both p

背景：牙源性颌骨囊肿是一种需要及时识别和处理的疾病。最初的诊断是基于临床和放射学表现和牙齿病史。根据临床和影像学表现，牙源性角化囊肿（OKC）有多种手术治疗方法。本报告和文献综述的目的是强调治疗OKC结合引导组织再生（GTR）的方法。方法：回顾性分析2例临床表现相似的病例。病例1是一名60岁的健康白人女性，在第21和22颗牙齿周围出现颌骨扩张。初步检查显示牙龈健康，牙周组织完整。患者x线片显示21 ~ 22号牙间牙龈组织增大，尺寸为9 × 12 mm，重要牙无牙根移位。病例2有类似的临床和影像学表现，位于牙齿# 5-6之间。结果：病例1的治疗包括切除活检和囊性病变完全去核。之后，采用同种异体移植物进行GTR，外部覆盖异种移植物，可吸收胶原膜（RCM），并进行初级闭合。病例2采用病变去核切除活检、同种异体骨移植、牙釉质基质衍生物和RCM的GTR和初级闭合。结论：矿化同种异体移植物、牙釉质基质衍生物、胶原膜或同种异体移植物外覆盖胶原膜分层技术的OKC去核联合GTR在6-36个月时牙周组织稳定，再生良好。重点：引导组织再生是一种可接受的治疗OKC的管理。OKC病变的完全去核对减少复发很重要。同种异体移植与异种移植或同种异体移植与牙釉质基质衍生物和RCM可以提供适当的骨填充。牙源性囊肿是生长在颌骨或牙齿周围的软组织中。如果不及时治疗，它们会变大，损害骨骼，甚至使牙齿错位。为了预防这种情况，及早诊断和切除是很重要的。治疗这些囊肿最常见的方法是通过一种叫做去核的手术方法，在这种方法中，囊肿被小心地移除。在这两个病例中，去核术与引导组织再生一起使用，这是一种帮助骨和组织在手术后更好愈合的技术。在第一种情况下，骨移植物（由人骨和动物骨制成）和一种称为可吸收胶原蛋白膜的特殊材料被用来保护和支持愈合区域。在第二种情况下，使用矿化骨移植物以及一种有助于修复组织的物质，称为牙釉质基质衍生物，以及相同的胶原蛋白膜。两名患者都愈合得很好，在接下来的6到36个月里，他们的牙齿周围的骨骼和组织都正常地再生了。

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引用次数: 0

Bone dimensions relationship with gingival phenotype in smokers and nonsmokers using cone-beam computed tomography. 使用锥形束计算机断层扫描研究吸烟者和非吸烟者的骨尺寸与牙龈表型的关系。

IF 0.9 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Advances in Periodontics

Pub Date : 2024-12-18 DOI: 10.1002/cap.10326

Shiva Barmar, Azadeh Torkzadeh, Roshanak Ghaffari, Shirin Zahra Farhad, Seyed Sasan Aryanezhad

Background: This study aimed to assess the relationship of maxillary alveolar bone thickness (BT) and height (BH) with gingival phenotype (GP) in smokers and nonsmokers using cone-beam computed tomography (CBCT).

Methods: This cross-sectional study was conducted on 60 participants. The participants underwent periodontal examination, and their GP was determined by placing a periodontal probe in the gingival sulcus at the midline and observing the transparency. The participants were then assigned to four groups (n = 15) based on their smoking status and GP: thin phenotype/smoker, thick phenotype/smoker, thin phenotype/nonsmoker, and thick phenotype/nonsmoker. BT and BH of the participants were measured in the sagittal plane on CBCT scans at the bone crest and at 2, 4, and 6 mm apical to the crest at the site of maxillary central and lateral incisors. Data were analyzed by two-way ANOVA and LSD test (alpha = 0.05).

Results: The distance between the cementoenamel junction (CEJ) of maxillary central and lateral incisors and alveolar bone crest in smokers was significantly greater than that in nonsmokers (p < 0.001). Smoking had no significant effect on alveolar BT at the crestal level or 2, 4, and 6 mm apical to the crest. BT at the crest and 2, 4, and 6 mm apical to the crest was significantly greater in thick, versus thin, GP (p < 0.001).

Conclusion: Smoking significantly increased the distance between the CEJ and alveolar crest at the site of central and lateral incisors but had no significant effect on BT.

Plain language summary: This study found that smoking significantly increased the distance between the cementoenamel junction and the alveolar bone crest in maxillary incisors but did not affect alveolar bone thickness, which was greater in individuals with a thick gingival phenotype compared to those with a thin gingival phenotype.

背景：本研究旨在利用锥形束计算机断层扫描（CBCT）评估吸烟者和非吸烟者上颌牙槽骨厚度（BT）和高度（BH）与牙龈表型（GP）的关系。方法：对60名被试进行横断面研究。参与者接受牙周检查，通过在龈沟中线处放置牙周探针并观察透明度来确定他们的GP。然后根据他们的吸烟状况和GP将参与者分为四组（n = 15）：瘦型/吸烟者、厚型/吸烟者、瘦型/不吸烟者和厚型/不吸烟者。在上颌中切牙和侧切牙的骨嵴和2、4、6 mm处的矢状面CBCT扫描上测量了参与者的BT和BH。数据分析采用双因素方差分析和LSD检验（α = 0.05）。结果：吸烟者上颌中、侧切牙牙釉质交界处（CEJ）与牙槽骨嵴之间的距离明显大于非吸烟者(p)。结论：吸烟可显著增加中、侧切牙牙釉质交界处（CEJ）与牙槽骨嵴之间的距离，但对bp无显著影响。本研究发现，吸烟显著增加了上颌切牙牙釉质交界处与牙槽骨嵴之间的距离，但不影响牙槽骨厚度，且在牙龈表型较厚的个体中比在牙龈表型较薄的个体中更大。

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引用次数: 0

In vitro ultrastructure and biodegradation of activated plasma albumin gel derived from human samples: A prospective observational study. 人血浆白蛋白凝胶的体外超微结构和生物降解：一项前瞻性观察研究。

IF 0.9 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Advances in Periodontics

Pub Date : 2024-12-18 DOI: 10.1002/cap.10330

Behzad Houshmand, Mohammadreza Talebi Ardakani, Farshad Armandei, Anahita Moscowchi, Ahmad Nazari, Jafar Ai, Mehdi Ekhlasmand Kermani, Hamoun Sabri

Background: In soft tissue regeneration, the clinical efficacy of fibrin membranes has been a pressing concern. The key to this efficacy lies in the stability of membrane and its controlled absorption. Human serum albumin, with its influence on the formation and stability of fibrin networks, could hold the key to developing a more stable alternative. This study investigates the ultrastructure and biodegradability of plasma albumin-activated gel, a potential game-changer in the field.Methods: Blood samples were collected from the participants and centrifuged to obtain the concentrated growth factor. The poor platelet plasma syringe was placed inside the activated plasma albumin gel device. The ultrastructure of the membrane was examined using a scanning electron microscope (SEM). The weight difference was measured over 21 days to investigate the biodegradability of the samples.Results: Twenty-two samples were prepared from six individuals (three males and three females). Based on SEM images, activated albumin gel after 21 days in Hank's solution exhibited a significant decrease in density and evident signs of surface degradation. The weight was significantly reduced after 21 days (p < 0.05).Conclusion: In the present study, the investigation of the ultrastructure and biodegradability of activated albumin gel showed that, based on the observed weight difference, the amount of biodegradation is high, and it may be necessary to use a thicker membrane compared to the conventional thickness of the connective tissue graft.Key points: Enhanced stability and biocompatibility: The study highlights plasma albumin-activated gel's potential as a soft tissue scaffold, demonstrating significant biodegradation and structural changes that support cell infiltration and nutrient exchange, essential for tissue regeneration. Controlled degradation profile: Plasma albumin gel offers a prolonged biodegradation period compared to conventional fibrin membranes, making it suitable for applications requiring stable, long-lasting scaffolds in soft tissue regeneration. Future clinical applications: Findings suggest that thicker plasma albumin membranes may be needed for optimal effectiveness, paving the way for further exploration in clinical trials and animal models to validate this approach in soft tissue grafting.Plain language summary: This study investigates plasma albumin-activated gel as a promising material for supporting soft tissue repair, particularly in periodontal regeneration. Traditional materials, such as fibrin membranes, are often used to aid healing, but their rapid breakdown can limit effectiveness in the body. Plasma albumin, a protein naturally found in human blood, might offer a more stable alternative by forming a longer-lasting structure. In this study, researchers processed blood samples from participants to cre

背景：在软组织再生中，纤维蛋白膜的临床疗效一直是人们迫切关注的问题。这种效果的关键在于膜的稳定性和对吸收的控制。人血清白蛋白对纤维蛋白网络的形成和稳定性有影响，可能是开发更稳定替代品的关键。本研究研究了血浆白蛋白活化凝胶的超微结构和生物降解性，这是该领域的潜在改变者。方法：采集受试者血样，离心提取浓缩生长因子。将不良血小板血浆注射器置于活化血浆白蛋白凝胶装置内。用扫描电镜观察了膜的超微结构。在21天内测量重量差，以研究样品的生物降解性。结果：从6个个体（男3名，女3名）中提取22份样本。扫描电镜显示，活化的白蛋白凝胶在Hank’s溶液中21天后，其密度明显下降，表面降解明显。结论：在本研究中，通过对活化白蛋白凝胶的超微结构和生物降解性的研究表明，基于观察到的重量差异，生物降解量很大，与常规结缔组织移植物厚度相比，可能需要使用更厚的膜。重点：增强的稳定性和生物相容性：该研究强调了血浆白蛋白活化凝胶作为软组织支架的潜力，证明了显著的生物降解和结构变化，支持细胞浸润和营养交换，这对组织再生至关重要。可控制的降解特性：与传统的纤维蛋白膜相比，血浆白蛋白凝胶提供了更长的生物降解期，使其适用于需要稳定、持久的软组织再生支架的应用。未来的临床应用：研究结果表明，为了达到最佳效果，可能需要更厚的血浆白蛋白膜，这为进一步的临床试验和动物模型探索铺平了道路，以验证该方法在软组织移植中的应用。摘要：本研究探讨血浆白蛋白活化凝胶作为一种有前途的材料支持软组织修复，特别是在牙周再生。传统的材料，如纤维蛋白膜，通常用于帮助愈合，但它们的快速分解会限制体内的效果。血浆白蛋白是一种天然存在于人体血液中的蛋白质，它可能会形成更持久的结构，从而提供更稳定的替代品。在这项研究中，研究人员处理了参与者的血液样本来制造凝胶，在强大的显微镜下检查其结构，并在21天内跟踪体重变化以评估其分解情况。结果表明，凝胶逐渐变得不那么致密，多孔性更强，允许细胞运动和营养物质流动，这对组织修复至关重要。此外，体重的显著减轻表明，随着时间的推移，病情得到了控制。这些发现表明血浆白蛋白活化凝胶可以作为一种更耐用的软组织再生支架，潜在地改善牙周应用中需要稳定、更持久材料的愈合结果。

{"title":"In vitro ultrastructure and biodegradation of activated plasma albumin gel derived from human samples: A prospective observational study.","authors":"Behzad Houshmand, Mohammadreza Talebi Ardakani, Farshad Armandei, Anahita Moscowchi, Ahmad Nazari, Jafar Ai, Mehdi Ekhlasmand Kermani, Hamoun Sabri","doi":"10.1002/cap.10330","DOIUrl":"https://doi.org/10.1002/cap.10330","url":null,"abstract":"Background: In soft tissue regeneration, the clinical efficacy of fibrin membranes has been a pressing concern. The key to this efficacy lies in the stability of membrane and its controlled absorption. Human serum albumin, with its influence on the formation and stability of fibrin networks, could hold the key to developing a more stable alternative. This study investigates the ultrastructure and biodegradability of plasma albumin-activated gel, a potential game-changer in the field.Methods: Blood samples were collected from the participants and centrifuged to obtain the concentrated growth factor. The poor platelet plasma syringe was placed inside the activated plasma albumin gel device. The ultrastructure of the membrane was examined using a scanning electron microscope (SEM). The weight difference was measured over 21 days to investigate the biodegradability of the samples.Results: Twenty-two samples were prepared from six individuals (three males and three females). Based on SEM images, activated albumin gel after 21 days in Hank's solution exhibited a significant decrease in density and evident signs of surface degradation. The weight was significantly reduced after 21 days (p < 0.05).Conclusion: In the present study, the investigation of the ultrastructure and biodegradability of activated albumin gel showed that, based on the observed weight difference, the amount of biodegradation is high, and it may be necessary to use a thicker membrane compared to the conventional thickness of the connective tissue graft.Key points: Enhanced stability and biocompatibility: The study highlights plasma albumin-activated gel's potential as a soft tissue scaffold, demonstrating significant biodegradation and structural changes that support cell infiltration and nutrient exchange, essential for tissue regeneration. Controlled degradation profile: Plasma albumin gel offers a prolonged biodegradation period compared to conventional fibrin membranes, making it suitable for applications requiring stable, long-lasting scaffolds in soft tissue regeneration. Future clinical applications: Findings suggest that thicker plasma albumin membranes may be needed for optimal effectiveness, paving the way for further exploration in clinical trials and animal models to validate this approach in soft tissue grafting.Plain language summary: This study investigates plasma albumin-activated gel as a promising material for supporting soft tissue repair, particularly in periodontal regeneration. Traditional materials, such as fibrin membranes, are often used to aid healing, but their rapid breakdown can limit effectiveness in the body. Plasma albumin, a protein naturally found in human blood, might offer a more stable alternative by forming a longer-lasting structure. In this study, researchers processed blood samples from participants to cre","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0